Sa1229 F-Calprotectin Use in Inflammatory Bowel Disease (IBD) Is Characterized by Improved Diagnostic Accuracy, Less Patient Harm and Decreased Costs, Compared With Conventional Serological Markers and Colonoscopy

Gastrointestinal disorders may exhibit overlapping symptoms making diagnosis difficult in the primary and specialty care settings. Inflammatory bowel disease (IBD), with a prevalence of <0.5% in the general population, is characterized by chronic inflammation of the gastrointestinal tract, non-specific elevation of conventional inflammatory markers such as ESR and CRP and may present with extra-intestinal manifestations. Irritable bowel syndrome (IBS), in contrast, is a functional disorder without gastrointestinal inflammation and with an estimated prevalence of 10-20%. Endoscopy is the gold standard for detecting and quantifying IBD vs. IBS, but due to the low prevalence of IBD, is negative in the majority of cases. Furthermore, it is invasive, expensive, and uncomfortable for the patient and not without risks. Moreover, inadequate bowel preparation prior to colonoscopy is known to increase the burden of disease from both the clinical and the economic perspective: shorter intervals between repeated procedures, higher missed rates, patient inconvenience, and increased risk of complications are reported in the scientific literature. F-Calprotectin (FC) is a fecal marker of intestinal inflammation; IBD patients exhibit FC levels significantly higher than the general population; IBS patients have FC levels higher than healthy controls, but significantly lower than IBD patients. Therefore, FC can be used as a pre-endoscopic test to differentiate between IBD and IBS. The present study aims at evaluating the cost-effectiveness of a) FC compared to b) the combined usage of CRP and ESR, and c) colonoscopy to distinguish IBD from IBS in the US.